This project will extend the collection and analysis of data from a prospective study that is currently in its 5th year. This first of its kind prospective study seeks to identify the primary biopsychosocial factors that contribute to the development and maintenance of myogenous TMD. The primary hypothesis that guides this work is that dysfunction(s) within CNS regulatory systems increases pain sensitivity and represents an important risk factor that contributes to the development of central sensitization which leads to persistent musculoskeletal pain conditions like myogenous TMD. In addition to extending this ongoing project, we will examine the ability of beta-adrenergic blockade to restore impaired pain regulatory systems and to diminish the signs and symptoms of FM and TMD. A randomized double blind mechanistic drug trial will examine whether beta-adrenergic blockade is able to impact pain and associated co-morbid conditions in patients with FM and TMD. The effects of short-term treatment with the nonselective beta-adrenergic antagonist propranolol or a placebo on pain regulatory systems and measures of pain, sleep and function, will be assessed in the home environment using diary procedures. The ability of beta-blockade to augment DNIC and to diminish central sensitization and windup in patients with FM and TMD will be examined.